Objective To discuss the clinical curative effect of pleating of levator palpebrae superioris in treating semiptosis. Design Retrospective case series. Participants Forty-three eyes from 30 patients with semiptosis of upper eyelid. Methods By using pleating of levator palpebrae superioris through the skin,isolating the levator muscle was skipped in rectification. Position of upper eyelid-margin before and after operation was observed. Main Outcome Measures The position change of upper eyelid-margin in the first position of eye in 3-6 months after surgery. Results The mean follow-up period was 13.1 months (6 months to 2 years),26 cases (39 eyes) got cured with normal eyelid-margin position,3 patients were below rectification and 1 patient over-rectification. Conclusion Pleating of levator palpebrae superioris is suitable for the treatment of semiptosis of upper eyelid.

OBJECTIVE:To establish a method for simultaneous determination of the content of 14 common metal elements (Mg,Ca,Cr,Mn,Fe,Ni,Cu,Zn,As,Se,Cd,Sb,Ba and Pb)in Ganmao qingre granules. METHODS:Microwave diges-tion-inductively coupled plasma mass spectrometry(ICP-MS)method was conducted. The samples were digested with concentrated nitric acid-hydrogen peroxide(2∶1,V/V),and then ICP-MS was used to determine the mass concentration of 14 metal elements. Li, Sc,Ge,Y,In,Bi and Tb were used as internal standards,and branches and leaves of bush were used as standard substances. RE-SULTS:The correlation coefficient of the standard curves of 14 elements was larger than 0.999 6,detection limits were in the range of 0.002-0.035 μg/L,recoveries were in the range of 80.57%-104.2% and RSDs were in the range of 0.34%-2.71%. CON-CLUSIONS:The method is specific,accurate and sensitive,and suitable for the content determination of 14 common metal ele-ments in Ganmao qingre granules. The total mass concentrations of 6 batches of heavy metals are all meet the requirements of Green Trade Standards of Importing&Exporting Medicinal Plants&Preparations.

OBJECTIVE:To establish the ion chromatography for the mass fractions of 9 inorganic anions (fluoride ion,for-mate radical,chloride ion,nitrite radical,bromide ion,nitrate radical,sulfate radical,oxalate radical and phosphate radical) in Ganmao qingre granules. METHODS:Ion chromatograph was used. The column was Ion Pac AS11-HC with the mobile phase of po-tassium hydroxide solution by gradient elution(concentration:30 mmol/L,time:15 min),the column temperature was room tem-perature,the volume was 25 μl. RESULTS:The 9 inorganic anions were basically achieved separation and had good linear relation-ship with r of 0.999 2-0.999 9,respectively;RSDs of precision,stability and reproducibility tests were less than 3.50%. Average re-covery was 92.47%-103.51%(RSD=0.42%-3.41%,n=6),respectively. CONCLUSIONS:The established method is fast,accu-rate,sensitive and repeatable and can be used for the determination of 9 inorganic anions in Ganmao qingre granules.

Objective:The best operation condition of extraction was found through analyzing the influences of both process of microwave pretreatment and hot wave washing. Methods: A new extraction method of chlorogenic acid was that the dry FLos Lonicerae was humidified with 75% ethanol-water solution at first, then the wet Flos Lonicerae was rapidly vaporized by microwave heating, at last chlorogenic acid was extracted after hot water washed twice, 10 minutes each time. Results: Compared with traditional extraction, the extraction time was about less than 6 times and then extraction ratio was increased by 1%. Conclusion: The method has high rate of extraction and short time of extraction.

PURPOSE: Alzheimer's disease (AD) is the sixth most common cause of death in the United States. MicroRNAs have been identified as vital players in neurodegenerative diseases, including AD. microRNA-128 (miR-128) has been shown to be dysregulated in AD. This study aimed to explore the roles and molecular mechanisms of miR-128 in AD progression. MATERIALS AND METHODS: Expression patterns of miR-128 and peroxisome proliferator-activated receptor gamma (PPAR-γ) messenger RNA in clinical samples and cells were measured using RT-qPCR assay. PPAR-γ protein levels were determined by Western blot assay. Cell viability was determined by MTT assay. Cell apoptotic rate was detected by flow cytometry via double-staining of Annexin V-FITC/PI. Caspase 3 and NF-κB activity was determined by a Caspase 3 Activity Assay Kit or NF-κB p65 Transcription Factor Assay Kit, respectively. Bioinformatics prediction and luciferase reporter assay were used to investigate interactions between miR-128 and PPAR-γ 3′UTR. RESULTS: MiR-128 expression was upregulated and PPAR-γ expression was downregulated in plasma from AD patients and amyloid-β (Aβ)-treated primary mouse cortical neurons (MCN) and Neuro2a (N2a) cells. Inhibition of miR-128 decreased Aβ-mediated cytotoxicity through inactivation of NF-κB in MCN and N2a cells. Moreover, PPAR-γ was a target of miR-128. PPAR-γ upregulation attenuated Aβ-mediated cytotoxicity by inactivating NF-κB in MCN and N2a cells. Furthermore, PPAR-γ downregulation was able to abolish the effect of anti-miR-128 on cytotoxicity and NF-κB activity in MCN and N2a cells. CONCLUSION: MiR-128 inhibitor decreased Aβ-mediated cytotoxicity by upregulating PPAR-γ via inactivation of NF-κB in MCN and N2a cells, providing a new potential target in AD treatment.
Alzheimer Disease ; Animals ; Blotting, Western ; Caspase 3 ; Cause of Death ; Cell Survival ; Computational Biology ; Down-Regulation ; Flow Cytometry ; Humans ; Luciferases ; Mice* ; MicroRNAs ; Neurodegenerative Diseases ; Neurons* ; Plasma ; PPAR gamma ; RNA, Messenger ; Transcription Factor RelA ; United States ; Up-Regulation

Objective Electrocardiographic(ECG) localization was used to guide the placement of peripherally inserted central catheters(PICC) catheter in the lower extremity. In clinical practice, the interference factors that may affect the localization results were further analyzed to reduce the interference factors. Methods From August 2016 to October 2018, Zhejiang Provincial People's Hospital implanted PICC catheter into the great saphenous vein of the lower extremity in 16 patients who had been placed into the central vein in advance because the upper extremity could not be placed into the PICC catheter. Based on the principle of ECG and the morphological change of P wave of ECG, the accuracy of the tip location of PICC guided by ECG was observed, and the possible interference factors in the process of ECG location were analyzed comprehensively, coping measures were implemented as well. Results 16 patients were guided by ECG to locate the tip of lower extremity PICC, 14 patients showed inverted P wave in ECG location, 16 patients showed the tip of catheter in the best position recommended by the guide on abdominal plain film, which was effective after targeted treatment of possible interference factors considered in the practice. Conclusions It is simple, safe and effective to use the ECG localization to locate the tip of PICC in lower extremity. It has better clinical practicability and popularization value.

Electronic health record is an important part of medical information research and has been widely used in medical institutions to help medical personnel deal with various medical information. However, due to the lack of standardized nursing language, nurses are often unable to reuse nursing data in electronic health records, which hinders the further development of medical information sharing and electronic health records. The use of standardized nursing language can support efficient and complete nursing documents in electronic health records and meet the requirements of clinical and data interoperability. This paper summarizes the definition and significance of electronic health record and standardized nursing language and the application status of standardized nursing language based on electronic health record, so as to provide scientific reference for the development and improvement of electronic health record in China.

Objective:To observe any effect of combining vibroacoustic therapy with audio-visual feedback on the swallowing and the emotional state of persons with a swallowing disorder after a brainstem stroke.Methods:Fifty brainstem stroke survivors with dysphagia were randomly divided into a control group and a combination group, each of 25. In addition to routine swallowing function training, the control group received additional direct feeding training, while the combination group was provided with vibroacoustic feeding training and swallowing stimulation from an animated audio-visual presentation. Before and after the treatment, the subjects′ swallowing function was quantified using the Standard Swallowing Assessment (SSA) scale and the Gugging swallowing screen (GUSS). The Positive and Negative Emotions Scale (PNAS) was used to quantify their emotional state.Results:After the treatment the average SSA scores of both groups had decreased significantly, while the average GUSS and PNAS scores had increased significantly. The average improvements in all three measures were significantly greater in the combination group than in the control group.Conclusion:In addition to routine swallowing function training, feeding training applying vibroacoustics and audio-visual stimulation can significantly improve the feeding function and emotional state of brainstem stroke survivors with dysphagia.

Since the concept of patient versions of guidelines （PVGs） was introduced into China， several PVGs have been published in China， but we found that there is a big difference between the concept of PVG at home and abroad， and the reason for this difference has not been reasonably explained， which has led to ambiguity and even misapplication of the PVG concept by guideline developers. By analyzing the background and purpose of PVGs， and the understanding of the PVG concept by domestic scholars， we proposed the term patient guidelines （PGs）. This refers to guidelines developed under the principles of evidence-based medicine， centered on health issues that concern patients， and based on the best available evidence， intended for patient use. Except for the general attribute of providing information or education， which is typical of common health education materials， PGs also provide recommendations and assist in decision-making， so PGs include both the patient versions of guidelines （PVG） as defined by the Guidelines International Network （GIN） and "patient-directed guidelines"， i.e. clinical practice guidelines resulting from the adaptation or reformulation of recommendations through clinical practice guidelines.

Standardized reporting is a crucial factor affecting the use of patient guidelines （PGs）， particularly in the reporting and presentation of recommendations. This paper introduced the current status of PG reporting， including the research on PG content and presentation formats， and provided comprehensive recommendations for PG reporting from aspects such as overall framework， recommendations， presentation format， and readability. First， the presentation of PG recommendations should include clearly defined clinical questions， recommendations and their rationale， and guidance on how patients should implement the interventions； for specific content in the PG， such as level of evidence， level of recommendation， it is recommended to explain in text the reasons for giving different levels of recommendation， i.e.， to present the logic behind giving the level of recommendation to the patient； additional information needed in the recommendation framework should be supplemented by tracing references or authoritative textbooks and literature that support the recommendations. Subsequently， the PG text should be written based on the Reporting Checklist for Public Versions of Guidelines （RIGHT-PVG） reporting framework. Finally， to enhance readability and comprehension， it is recommended to refer to the Patient Education Materials Assessment Tool （PEMAT） for translating PG content. To enhance the readability of PGs， it is suggested to present the PG content in a persona-lized and layered manner.